Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207ND0900X | Dermatopathologist | 39206 | MA |
NPI | 1538112560 |
---|---|
Provider Name | Dr. William W Stocker |
First Address | Sandwich, MA 02563 |
Second Address | Annapolis, MD 21409-4699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B75407 | (02) | MA |